Need for knowledge translation to improve tumor marker application
Int J Biol Markers 2016; 31(4): e331 - e331
Article Type: EDITORIAL
Article Subject: Diagnostic Biomarkers
- • Accepted on 13/12/2016
- • Available online on 22/12/2016
- • Published online on 23/12/2016
This article is available as full text PDF.
Download any of the following attachments:
The development of strategies to implement CPGs falls into the area of research defined as “knowledge translation” (4). In the case of circulating TMs, this area encompasses several issues, including guideline implementation and identification of questions requiring further research (4). IJBM is evaluating the opportunity of launching in 2017 a call for papers dedicated to knowledge translation on circulating TMs, in hopes that this will contribute to narrowing the gap between the rapidly growing knowledge and the clearly still ineffective clinical application of TMs.
I am therefore pleased to open this field of interest of IJBM with the publication of the English version of a guidance document aimed at assisting in the implementation of CPGs regarding the clinical use of TMs. The document was published in Italy in October 2016 by the Italian National Agency for Regional Health Services (AGENAS) on behalf of and in collaboration with 9 Italian scientific societies representative of a variety of stakeholders (5). The project was planned and managed by the Regional Center for Biomarkers of Venice, which coordinated the teamwork of an expert panel of 74 members. The guidance document in English will be published in 3 parts; the first part, appearing in the present issue, concerns the malignancies of the gastrointestinal tract; two other parts will follow in 2017.
The project was grounded on the awareness that different CPGs may assume different positions on the same clinical question; in fact, some CPGs formulate recommendations while others do not, or there may be poor consistency between recommendations put forward by different CPGs. We therefore developed a tool to summarize the information on circulating TMs offered by the available CPGs on solid tumors, using a structured and rigorous methodology. The goal is to supply health care providers and policy makers facing clinical questions where the use of a TM could be considered with all possible evidence-based choices. Recommendations were extracted from CPGs and ordered by individual malignancies. They were clustered according to a set of clinical questions and summarized, at increasing levels of synthesis, into
We sincerely hope that the publication of the present guidance document (6) will stimulate extensive discussion and promote commentaries and debate, with the ultimate ambition of improving the appropriate use of TMs but also optimizing the proposed model of comparative summary of the available evidence to facilitate extensive dissemination and consultation of the guidance provided.
Gion M Peloso L Trevisiol C et al. An epidemiology-based model as a tool to monitor the outbreak of inappropriateness in tumor marker requests: a national scale study. 2016 54 473 482
Zhi M Ding EL Theisen-Toupal J et al. The landscape of inappropriate laboratory testing: a 15-year meta-analysis. 2013 8 e78962
Moynihan R Henry D Moons KG Using evidence to combat overdiagnosis and overtreatment: evaluating treatments, tests, and disease definitions in the time of too much. 2014 11 e1001655
Straus SE Tetroe J Graham I Defining knowledge translation. 2009 181 165 168
Gion M Trevisiol C Rainato G Fabricio ASC Marcatori circolanti in oncologia: guida all'uso clinico appropriato. Roma, IT: AGENAS, Agenzia Nazionale per i Servizi Sanitari Regionali; 2016;1-179.
Gion M Trevisiol C Rutjes AWS Rainato G Fabricio ASC Circulating tumor markers: a guide to their appropriate clinical use. 2016 31 e332 e367